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Organization
NEW CREATION HEALING CENTER, INC
Active
Organization
NEW CREATION HEALING CENTER, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARY G PEARSON DO (COO/PHYSICIAN)
(603) 642-6700
Entity
Organization
Contact information
Practice address
80 ROUTE 125, KINGSTON, NH 03848-3535
(603) 642-6700
(603) 642-6701
Mailing address
80 ROUTE 125, KINGSTON, NH 03848-3535
(603) 642-6700
(603) 642-6701
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
NULL
207Q00000X
Family Medicine Physician
Primary
—
—
363L00000X
Nurse Practitioner
—
NULL
363L00000X
Nurse Practitioner
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
30900090
—
NH
05
—
9785515
—
MA
01
—
BCBS
M17086
MA
01
—
HEALTHSOURCE
15221
NH
01
—
TUFTS
681554
MA
Enumeration date
08/01/2006
Last updated
03/05/2009
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